Register Your Health Brand

It takes about 10 minutes. No credit card required.

1

Brand Basics

connect-scripts.com/intake/

Auto-generated from your brand name. You can update this later.

Format: XX-XXXXXXX

e.g. example.com or https://example.com

https:// will be added automatically if missing

2

Your Team

3

Programs

Select all programs you plan to offer.

4

Integration

Intake Source
Payment Source
Provider Upsell
Refill Mode

💳 No Stripe keys yet? No problem — we'll walk you through it after registration. You can also add keys later in your admin dashboard.

5

Providers

✓ We provide licensed providers.

Also available for your LegitScript certification — ask your account rep after registration.

6

Pharmacy

7

Compliance (LegitScript)

8

Anything else?

Anything else? Upload it here — product lists, credentials, docs.

📎

Drop files here or click to browse

PDF, PNG, JPG, DOCX — up to 50 MB

Examples: brand logo, product photos, marketing materials, screenshots of your current funnel, color palette — anything that helps us build your survey and brand correctly

9

Want to get live faster?

Optional services. No credit card required to register.

10

Agreement

No credit card required to register. Services are optional.